Clinical outcome and peripheral immune profile of myasthenic crisis with omicron infections: A prospective cohort study

Xiao Huan; Jialin Chen; Huahua Zhong; Yafang Xu; Yuan Wang; Haoqin Jiang; Jie Song; Chong Yan; Jianying Xi; Zhangyu Zou; Jianming Zheng; Zhe Ruan; Song Tan; Lijun Luo; Sushan Luo; Chongbo Zhao; Pan-Yangtze River Delta Alliance for Neuromuscular Disorders (PYDAN)

doi:10.1016/j.clim.2023.109879

Clinical outcome and peripheral immune profile of myasthenic crisis with omicron infections: A prospective cohort study

Clin Immunol. 2024 Feb:259:109879. doi: 10.1016/j.clim.2023.109879. Epub 2023 Dec 22.

Authors

Xiao Huan¹, Jialin Chen², Huahua Zhong¹, Yafang Xu¹, Yuan Wang³, Haoqin Jiang⁴, Jie Song¹, Chong Yan¹, Jianying Xi¹, Zhangyu Zou², Jianming Zheng⁵, Zhe Ruan⁶, Song Tan⁷, Lijun Luo⁸, Sushan Luo⁹, Chongbo Zhao¹⁰; Pan-Yangtze River Delta Alliance for Neuromuscular Disorders (PYDAN)

Affiliations

¹ Huashan Rare Disease Center and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Center for Neurological Disorders, Fudan University, Shanghai 200040, China.
² Department of Neurology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
³ Department of Blood Transfusion, Huashan Hospital, Fudan University, Shanghai 200040, China.
⁴ Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
⁵ Department of Infectious Diseases, Huashan Hospital, National Medical Center for Infectious Diseases, Fudan University, Shanghai 200040, China.
⁶ Department of Neurology, Tangdu Hospital, The Air Force Medical University, Xi'an 710000, China.
⁷ Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
⁸ Department of Neurology, Wuhan No.1 Hospital, Wuhan 430030, China.
⁹ Huashan Rare Disease Center and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Center for Neurological Disorders, Fudan University, Shanghai 200040, China. Electronic address: luosushan@fudan.edu.cn.
¹⁰ Huashan Rare Disease Center and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Center for Neurological Disorders, Fudan University, Shanghai 200040, China. Electronic address: zhao_chongbo@fudan.edu.cn.

PMID: 38142901
DOI: 10.1016/j.clim.2023.109879

Abstract

The impact of Omicron infections on the clinical outcome and immune responses of myasthenia gravis (MG) remained largely unknown. From a prospective multicenter MG cohort (n = 189) with 197 myasthenic crisis (MC), we finally included 41 independent MG patients to classify into two groups: the Omicron Group (n = 13) and the Control Group (n = 28). In this matched cohort study, all-cause mortality was 7.69% (1/13) in Omicron Group and 14.29% (4/28) in Control Group. A higher proportion of elevated serum IL-6 was identified in the Omicron Group (88.89% vs 52.38%, P = 0.049). In addition, the proportions of CD3⁺CD8⁺T in lymphocytes and Tregs in CD3⁺CD4⁺ T cells were significantly elevated in the Omicron Group (both P = 0.0101). After treatment, the Omicron Group exhibited a marked improvement in MG-ADL score (P = 0.026) and MG-QoL-15 (P = 0.0357). MCs with Omicron infections were associated with elevated serum IL-6 and CD3⁺CD8⁺T response. These patients tended to present a better therapeutic response after fast-acting therapies and anti-IL-6 treatment.

Keywords: Clinical outcome; Interleukin-6; Myasthenic crisis; Omicron infections; Peripheral immune.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Humans
Interleukin-6*
Myasthenia Gravis* / drug therapy
Prospective Studies
Quality of Life

Substances

Interleukin-6